Beneficial effects of long-acting nifedipine on coronary vasomotion abnormalities after drug-eluting stent...

Area of Science:

• Cardiovascular Medicine
• Interventional Cardiology
• Pharmacology

Background:

• Drug-eluting stents (DES) are known to induce coronary vasomotion abnormalities.
• Previous studies showed long-acting nifedipine suppressed these responses with first-generation DES.
• Second-generation DES, like everolimus-eluting stents (EES), are widely used globally.

Purpose of the Study:

• To investigate if long-acting nifedipine also mitigates coronary vasomotion abnormalities induced by second-generation EES in humans.
• To assess the impact of long-acting nifedipine on vascular inflammation in patients with EES.

Main Methods:

• A prospective, randomized, multicentre trial (NOVEL Study) involving 100 patients with stable angina.
• Patients received either conventional treatment or conventional treatment plus long-acting nifedipine.
• Coronary vasoreactivity to acetylcholine was assessed via quantitative coronary angiography after 8-10 months.

Main Results:

• Coronary vasoconstricting responses to acetylcholine were significantly enhanced at the distal edge of EES.
• Long-acting nifedipine significantly suppressed these vasoconstricting responses compared to the control group.
• Serum levels of high-sensitivity C-reactive protein and adiponectin improved in the nifedipine group, indicating reduced inflammation.

Conclusions:

• Coronary vasomotion abnormalities remain a clinical issue with second-generation DES.
• Long-acting nifedipine demonstrates beneficial effects in suppressing these abnormalities.
• The positive effects of nifedipine are associated with its anti-inflammatory properties.